Why Choose NLPHO?

Northeast Louisiana Physician Hospital Organization (NLPHO), a successful partnership of top physicians and hospitals, serves northeast Louisiana via its comprehensive network, delivering quality and affordable healthcare to its members. NLPHO’s broad, regional presence provides both access and choice. This gives plan members convenience and the opportunity to see physicians they know and trust. As a locally owned and operated entity, NLPHO understands the needs of our community and our providers.

Participation in NLPHO has its advantages

Because our contracted payors “delegate” their credentialing to us, this is one of our most important functions. This means that we assume the liability and responsibility to verify our providers on their behalf. Upon receipt of a credentialing application, we take it from there as our credentialing process meets or exceeds the National Committee for Quality Assurance’s (NCQA) and other regulatory agency’s standards. And, providers approved by our Board of Directors immediately gain access to the many covered lives accessing our network. The bottom line is that NLPHO does the work.

A successful contract benefits both the provider network and the payor. Consequently, we strive to form a mutually beneficial partnership between the parties with one goal in mind….to provide quality care at an affordable price to the many plan members we serve. Of course, for non-risk contracts, the financial terms are not negotiated by the PHO due to anti-trust issues. The financial terms must be negotiated by providers individually for each payor contract.

Messenger Model:
Our providers decide whether or not to participate. NLPHO provides a product overview, including a fee schedule. Upon signing the enrollment form, the process for participation begins. And, NLPHO acts as a liaison between the provider and the payor. Additionally, we remain available to provide assistance with claims issues, utilization and the identification of PHO contracted plan members.

Clinical Initiatives:
In this increasingly important area, we have initiated audits/studies over the past several years. These ongoing initiatives have been educational and beneficial for our providers as we all work to bring continuous quality improvements to the patients we serve. Our goal is to offer quality improvements in the most cost effective manner.

Other Benefits:

NLPHO offers group discounted professional liability insurance and education for both physicians and their office staff. We publish a newsletter on our website, which includes up-to-date information about our contracted payors, news on Federal health plans, new employer groups and much more. Additionally, we can link your website to ours which allows plan members access to information about your clinic.

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